Substance Use Disorder

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Admission to Recovery Services Increased

A broad spectrum of public health and safety problems are directly linked to the disease of substance use disorder, including addiction, traffic accidents, domestic violence, crime, unintended pregnancy, and serious conditions such as cancer, liver disease, HIV/AIDS, and birth defects. Youth who engage in drinking and substance use early are more likely develop alcohol dependence later in life and are more likely to experience changes in brain development that may have life-long effects, including problems with memory and normal growth and development.[1]This indicator presents a variety of commonly used indicators to help gauge the extent of substance use disorder (SUD) in San Bernardino County. These include trends in SUD-related admissions to County recovery facilities, serious (injury or fatal) alcohol-involved auto collisions, and SUD-related deaths including fentanyl-related deaths.

TREND

SUD Recovery Services for Adults

SUD-related admissions for adults (18 years and older) to County recovery facilities rose 7% between 2020/21 and 2021/22, yet admissions remain down 30% from five years ago (2017/18 – 2021/22). Over this period, there was a 173% increase in admissions for “other drugs,” which may include tranquilizers, sedatives, hallucinogens, inhalants, or other drugs.  Meanwhile, there were double digit decreases for admissions for methamphetamines, opiates, cannabis, cocaine, and alcohol. Twenty-five percent of adult clients receiving SUD services also received County mental health services in 2021/22, while 31% have received mental health services in their lifetimes.[2] Methamphetamines and opiates accounted for 33% and 32% of adult admissions, respectively.

SUD-RELATED ADMISSIONS TO RECOVERY FOR MOST SUBSTANCES CONTINUES TO DECLINE
Number of Alcohol- and Drug-Related Adult Admissions to County-Funded Recovery Services in San Bernardino County, 2018-2022

Source: County of San Bernardino, Department of Behavioral Health, CalOMS Dataset

SUD Recovery Services for Youth

SUD-related admissions for youth (younger than 18 years) to County recovery facilities rose 52% between 2020/21 and 2021/22.  Over the past five years, however, admissions dropped by 31%.  Over this period, there was a 380% increase in opiate-related youth admissions. Sixty-two percent of youth clients receiving SUD services also received County mental health services in 2021/22.[3] Cannabis and opiates accounted for 69% and 16% of youth admissions, respectively.

SUD-RELATED YOUTH ADMISSIONS INCREASED IN 2021/22
Number of Alcohol- and Drug-Related Youth Admissions to County-Funded Recovery Services in San Bernardino County, 2018-2022

Source: County of San Bernardino, Department of Behavioral Health, CalOMS Dataset

Alcohol-Involved Collisions

The number of alcohol-involved accidents rose 12% at the county level between 2020 and 2021 and 10% statewide. In 2021, 12% of serious collisions in San Bernardino County involved alcohol, compared to 13% of collisions statewide. Over the past 10 years, alcohol-involved collisions per capita have fluctuated to a present rate of 58 per 100,000 in 2021 – higher than the statewide rate of 51 per 100,000. In 2021, alcohol-involved collisions claimed 104 lives in San Bernardino County.

SAN BERNARDINO HAS HIGHER RATE OF ALCOHOL-INVOLVED COLLISIONS THAN THE STATE
Number of Alcohol-Involved Serious Collisions per 100,000 Residents in San Bernardino County and California, 2012-2020

SUD-Related Deaths
Over the past 10 years, drug-induced and alcohol-related deaths increased.  Since the 10-year low in 2012 of 9.2 drug-induced deaths per 100,000 residents, drug-induced deaths in San Bernardino County increased annually to a 2020 rate of 18.2 deaths per 100,000. The statewide rate for drug-induced deaths is 17.8 per 100,000. Deaths caused by chronic liver disease and cirrhosis, which are often associated with substance use disorder, have worsened, from 12.6 per 100,000 in 2011 to 17.8 per 100,000 in 2020. The county has more chronic liver disease and cirrhosis deaths than the statewide average (12.6 per 100,000 in 2020).

DRUG AND ALCOHOL RELATED DEATH RATES CONTINUE TO INCREASE
Drug and Alcohol-Related Death Rates in San Bernardino County, 2011-2020

Note: Data reflect rolling three-year averages, where “2020” includes data from 2018, 2019 and 2020.  Death rates are age-adjusted per 100,000 residents.

Source: California Department of Public Health, County Health Status Profiles, 2022

Between 2016 and 2021, the number of deaths related specifically to fentanyl rose precipitously, from six deaths in 2016 to 316 deaths in 2021. This represents an increase of 5,167%. The one-year increase is 25%, up from 252 deaths in 2020.

FENTANYL-RELATED DEATHS SURGE MORE THAN FIFTY-FOLD SINCE 2016
Number of Fentanyl-Related Deaths in San Bernardino County, 2016-2021

RACE/ETHNICITY DETAIL

Half (50%) of young clients served by County substance use disorder recovery services are Latino, followed by White (22%) and Black (17%) clients.  For adults, 42% of those in SUD recovery services are White, followed by Latino (39%) and Black clients (11%).

HALF OF YOUTH SERVED BY COUNTY SUD RECOVERY SERVICES ARE LATINO

Distribution of Unduplicated SUD Youth and Adult Clients by Race/Ethnicity in San Bernardino County, 2021/22

Youth
Adults

The Mental Health/Substance Use Disorder Connection

Mental health and substance use disorder are often interconnected.  More than 8.9 million people nationally are reported to have co-occurring mental health and substance use disorders.  When treated concurrently, treatments are found to be more effective.  Treating the whole person improves wellbeing by leading to reductions in addiction relapse, reemergence of psychiatric symptoms, and utilization of crises intervention services.

Source: County of San Bernardino, Department of Behavioral Health


[1] Centers for Disease Control and Prevention (www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm)

[2] San Bernardino County, CalOMS dataset

[3] San Bernardino County, CalOMS dataset

1Centers for Disease Control and Prevention (www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm) 2San Bernardino County CalOMS dataset